In females between the age of menarche and menopause, the normal vagina provides an ecosystem for a variety of microorganisms that is typically maintained in a relatively delicate balance. Bacteria are the predominate type of microorganisms present in the vagina, and most women harbor about 107 to 109 colony forming units (CFU) per ml of vaginal secretion. The more commonly isolated bacteria include lactic acid bacteria, Lactobacillus species, Corynebacteria species, Gardnerella vaginalis, Staphylococcus species, Peptococcus species, aerobic and anaerobic streptococcal species, Bacteroides species and Prevotella species. Other microorganisms that have been isolated from the vagina on occasion include yeast (Candida albicans), protozoa (Trichomonas vaginalis), mycoplasma (Mycoplasma hominis), chlamydia (Chlamydia trachomatis), and viruses (Herpes simplex). These latter organisms are generally associated with vaginitis or sexually transmitted diseases, although they may be present in low numbers without causing symptoms.
Physiological, social and idiosyncratic factors can affect the cell density and species of microbes present in the vagina. Physiological factors can include age, day of the menstrual cycle, and pregnancy. Social and idiosyncratic factors can include presence and method of birth control, sexual practices, systemic disease (e.g., diabetes), and medication. Disruption of the vaginal ecosystem, such as, e.g., normal healthy vaginal microflora, can permit opportunistic infections to emerge.
Toxic shock syndrome (“TSS”) is characterized by rapid onset of high fever, vomiting, diarrhea and rash followed by a drop in blood pressure and vital organ failure. The causative agent of toxic shock syndrome is thought to be exotoxin-producing cocci, such as, e.g., Staphylococcus, e.g., S. aureus, and/or Streptococcus, e.g., S. pyogenes. The exotoxins associated with TSS can include, for example, Staphylococcus: Enterotoxin A, Enterotoxin B, Enterotoxin C, and Toxic Shock Syndrome Toxin-1 (TSST-1), and Streptococcus: pyrogenic Exotoxin A, Exotoxin B, Exotoxin C. It is believed that TSS is not caused by the presence of the bacteria per se, but rather by the toxic effects of the associated exotoxin.
TSS has been associated with the use of absorbent articles within the vagina. The syndrome has also been observed with surgical dressings and nasal packing. TSS appears to occur with elevated frequency in association with absorbent pads having high levels of absorbency.
Various modifications to the absorbent articles have been proposed to reduce the risk of TSS associated with absorbent articles. Typically, such modifications can adversely affect levels of S. aureus, or other bacteria that make up the vaginal microflora, such as, e.g., by employing antimicrobials or bactericidal agents. These effects can upset the healthy balance discussed above. In addition, modifications to the absorbent article may not be compatible with manufacture and/or storage techniques and/or may degrade over time.
Accordingly, it would be desirable to provide an improved article, including an absorbent article suitable for use in and around the mammalian vagina, which reduces or prevents the production of TSST-1.